Reaping the Gains of Stringent Efforts in Malawi’s MDR TB Fight

Twenty-five-year-old Blessings Crazer says 'never say never' when challenges strike.

He won his fight against multi drug resistant (MDR) Tuberculosis (TB) and urges all in such a situation to always keep hope.

Crazer tells the story of how he had to endure swallowing 16 pills in one goal each day plus one injectable drug until his victory of cure.

"l tried to follow the doctors' instructions. Here I am today. l thank God that I am alive," he says, noting, however, that society has not fully accepted him back.

He still faces citing stigma and discrimination. But, still, Crazer is now back in his bicycle taxi (kabaza) business raising money to support his family.

"Go to the hospital for TB testing and start treatment in good time if tested positive," he advised Malawians.

His sentiments are echoed by Aubi Mussa from Chimwala in Mangochi, who tested positive for TB in 2018 while living in South Africa.

Mussa returned home in 2019 and he started his 18-month TB treatment.

"Suffering from TB is not easy. l was weak until l started TB treatment. I was taking over 20 tablets a day; then my health improved," he recalls.

"Doctors were so supportive. My relatives were supportive...l followed all procedures, taking the medication, and I recovered. Now, I am TB free. I am able to do piece works not to earn a living,” says Mussa.

Mussa tells us that he was worried thinking he will die, but the doctors’ advice helped him a lot to recover.

Mussa has advised those on treatment to take medication and follow doctors’ instructions.

The story of Mussa and Crazer – proper adherence to medication and taking nutritious food when one is sick – is what has made Malawi emerge a winner in the fight against of the hardest to treat ailments in the world. But there is more!

The National TB and Leprosy Elimination Program says provision of transport money to all the 165 patients currently on multi drug resistant TB is helping them not to shun medical treatment.

Coordinator for MDR TB treatment Yusuf Sayidi told Zodiak Online that the patients are no longer missing hospital appointments.

"We conduct monthly clinics on MDR TB to make sure the patients are taking medication and identify any side effects as well as to manage the side effects before their condition worsens.

"So, provision of transport money is helping them to visit health facilities in good time to collect medication and undergo for checkup,” said Sayidi.

He said, currently, Malawi has 165 patients:103 males and 62 females on MDR TB treatment.

Sayidi said the number of men suffering from MDR TB is higher than that of women because of life style, particularly on travel.

Psychosocial & Nutrition Support Officer in the ministry of health Chrissy Padoko said they are also providing food items to all MDR TB patients in the country.

"We are providing cooking oil, beans, Likuni phala (nutritional porridge flour), maize flour, sugar and milk to all the 160 MDR TB patients in the country.

"These patients take powerful drugs hence provision of food items every six month to improve their health," said Padoko.

She added that due to the psychological effects of TB, the patients are provided with psycho-social support.

Currently, treatment success rate for MDR TB is at 75 percent, thanks to the interventions that have been undertaken over the years.

Programmes Manager for National TB and Leprosy Elimination Programme Dr James Mpunga told Zodiak Online that the treatment success rate has risen from 55% in 2021 to 75% in 2022.

Dr Mpunga attributes this change, not only to the interventions such as provision of food items to patients, but following up on all MDR TB patients to ensure they are taking their medication correctly.

“This is very important because it is the most essential aspect of all these strategies,” he says, “We have worked hard over the years to improve the adherence rate to medication as well.”

MDR TB is caused by TB bacteria that are resistant to at least isoniazid and rifampin, the two most potent TB drugs, according to the Centres for Disease Control (CDC) of the US government.

It starts when the drugs used to treat TB are misused or mismanaged. Examples of misuse or mismanagement include people not completing a full course of TB treatment, health care providers prescribe the wrong treatment and drugs of poor quality.

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